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50 Year Old Woman, Non Smoker, Non Drinker. Normal Weight,
Question: 50 year old woman, non smoker, non drinker. Normal weight, exercise and eat appropriately. Diangosed with gastroperisis , have a 2CM cyst in right hepatic lobe and have had for a year +. Have had pain in right liver area under breastbone for over a year. GI seems content just telling me to take my domperadone and eat slowly, eat small meals. I still get pain when I eat badly enough that it radiates to sides and back to the point I can barely stand pretty much every nite. Should I look closer at liver or pancreas ????
Brief Answer:
If you could please provide more details
Detailed Answer:
Hi and Welcome to ask a doctor service. I have read your question and here is my advice.
Really sorry to hear about your disease.To try to understand better about what might be causing your pain and how to proceed, we need to know more about the pain. It would be great if you could please provide us answers to the following questions.
1. Were you told as what caused your gastroperesis.? And what tests were done for it.
2.where is the pain, like centre off the tummy, left or right side, or while tummy.?
3. Is the pain occur only after meals, and how much time after meal and how much much time it settles down.?
4.do you have any other problems with it like fever, vomiting, or loose motions.?
5.did you loose weight.?
Please let us know what tests you have done. Also would be great if you could send the ct scan repert again if was possible for you.
Looking forward your response.
Regards Dr Mahboob ur Rahman
If you could please provide more details
Detailed Answer:
Hi and Welcome to ask a doctor service. I have read your question and here is my advice.
Really sorry to hear about your disease.To try to understand better about what might be causing your pain and how to proceed, we need to know more about the pain. It would be great if you could please provide us answers to the following questions.
1. Were you told as what caused your gastroperesis.? And what tests were done for it.
2.where is the pain, like centre off the tummy, left or right side, or while tummy.?
3. Is the pain occur only after meals, and how much time after meal and how much much time it settles down.?
4.do you have any other problems with it like fever, vomiting, or loose motions.?
5.did you loose weight.?
Please let us know what tests you have done. Also would be great if you could send the ct scan repert again if was possible for you.
Looking forward your response.
Regards Dr Mahboob ur Rahman
Above answer was peer-reviewed by :
Dr. Prasad
1. The nuclear egg , wait 90 minutes to see how fast I digest and it took 204 min. Apparently 90 is norm
2. Under right breast and around to top from inside toward ch est versus toward armpit (breast issue has been ruled out)
3.pain is within a few minutes of finishing food
4. No fever or weight loss but lots of trouble breathing not related to exercise. Lungs ruled out too
2. Under right breast and around to top from inside toward ch est versus toward armpit (breast issue has been ruled out)
3.pain is within a few minutes of finishing food
4. No fever or weight loss but lots of trouble breathing not related to exercise. Lungs ruled out too
Brief Answer:
CT scan best to see pancreas
Detailed Answer:
Hi..thanks for providing the details.
The pain does not look to be from pancreas. As that is central and many times associated with weight loss and loose motions. The ct scan is the best test to see for pancreas, and if your ct scan report is normal (unfortunately the report does not open with me) this is very unlikely to be related to pancreas.
We need to focus on the liver cyst. Liver cysts can produce pain and the area you mention do respond to that. However we need to know more about the cyst. Because 2 cm cysts most of the times do not cause so severe pain. ct can in necessary, specially to see the location of cyst, its consistency(like complex or simple ), and any changes like blood in it or infection in it. This is best seen by ct scan or ultrasound.
We also need to know why you have gastroperesis and if it can somehow relate to your pain. Like stomach distention after meal may cause pressure effects and causing pain.
Other problem that may explain the pain is to see about gall badder, and hepatbeliary channels( small channels in liver ). Very rarely stenosis (narrowing) of the vessel which supply stomach may also cause severe pain after meals. This is like angina of stomach. That's unlikely in healthy peoples.but still just a possibility if you risk for it like high cholesterol, diabetes , hypertension , etc
So I would like to get scan of your tummy (I under stand its already done but see if that is normal ) and to proceed with MRCP (another type of scan) to know about the pain.
If there is any suspicioun that the cyst may possible be causing the pain we may need to remove that.
An endoscopy (if not already done) to rule out ulcer in your stomach is also necessary. Ulcer do commonly occurs in gastroperesis and need not to be ignored.
So the possible causes are many, discuss this with your doctor, show them your concern, i am sure they would like to address your concerns.
Best luck.
Please Don't hesitate to ask if you have any further questions.
CT scan best to see pancreas
Detailed Answer:
Hi..thanks for providing the details.
The pain does not look to be from pancreas. As that is central and many times associated with weight loss and loose motions. The ct scan is the best test to see for pancreas, and if your ct scan report is normal (unfortunately the report does not open with me) this is very unlikely to be related to pancreas.
We need to focus on the liver cyst. Liver cysts can produce pain and the area you mention do respond to that. However we need to know more about the cyst. Because 2 cm cysts most of the times do not cause so severe pain. ct can in necessary, specially to see the location of cyst, its consistency(like complex or simple ), and any changes like blood in it or infection in it. This is best seen by ct scan or ultrasound.
We also need to know why you have gastroperesis and if it can somehow relate to your pain. Like stomach distention after meal may cause pressure effects and causing pain.
Other problem that may explain the pain is to see about gall badder, and hepatbeliary channels( small channels in liver ). Very rarely stenosis (narrowing) of the vessel which supply stomach may also cause severe pain after meals. This is like angina of stomach. That's unlikely in healthy peoples.but still just a possibility if you risk for it like high cholesterol, diabetes , hypertension , etc
So I would like to get scan of your tummy (I under stand its already done but see if that is normal ) and to proceed with MRCP (another type of scan) to know about the pain.
If there is any suspicioun that the cyst may possible be causing the pain we may need to remove that.
An endoscopy (if not already done) to rule out ulcer in your stomach is also necessary. Ulcer do commonly occurs in gastroperesis and need not to be ignored.
So the possible causes are many, discuss this with your doctor, show them your concern, i am sure they would like to address your concerns.
Best luck.
Please Don't hesitate to ask if you have any further questions.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Forgot no gallbladder. Removed in 2016 as was functioning at 8% per HIDA
Also tested 2x positive ANA at 160 titer. Rheumatologist dismissed lupus though I'm not convinced
Laparoscopy revealed scarring near liver but was done by OB and he said he doesn't touch liver but mentioned to GI and he seems unconcerned since bloodwork is all normal .
Also tested 2x positive ANA at 160 titer. Rheumatologist dismissed lupus though I'm not convinced
Laparoscopy revealed scarring near liver but was done by OB and he said he doesn't touch liver but mentioned to GI and he seems unconcerned since bloodwork is all normal .
Brief Answer:
See details please
Detailed Answer:
Hi.
Positive ANF does not mean SlE, so the rheumatologist looks right. SlE has many other symptoms like joint pain fever and many others.
I still understand its probably the gastroenteralogist to talk to. All the causes I mentioned previous are possibilities.
There is a syndrome called post cholecystectomy syndrome, thats also need mention.
So talk to your gastroenteralogist. I hope he would address your concern.
See details please
Detailed Answer:
Hi.
Positive ANF does not mean SlE, so the rheumatologist looks right. SlE has many other symptoms like joint pain fever and many others.
I still understand its probably the gastroenteralogist to talk to. All the causes I mentioned previous are possibilities.
There is a syndrome called post cholecystectomy syndrome, thats also need mention.
So talk to your gastroenteralogist. I hope he would address your concern.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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